Provider Demographics
NPI:1982118907
Name:WAITE VISION, PLLC
Entity Type:Organization
Organization Name:WAITE VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:NOBLE
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-469-3090
Mailing Address - Street 1:3333 N DIGITAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6694
Mailing Address - Country:US
Mailing Address - Phone:801-876-6000
Mailing Address - Fax:
Practice Address - Street 1:3333 N DIGITAL DR STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6694
Practice Address - Country:US
Practice Address - Phone:801-876-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10314201-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty